Beachley Business & Medical Forms, Inc. :: Health Care Claim Products :: UB-04 Forms (Formerly UB-92)

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Beachley Business & Medical Forms, Inc. :: Health Care Claim Products :: UB-04 Forms (Formerly UB-92) :: Laser UB-04 Form

Laser UB-04 Form

NEW Laser UB-04 Form

8 1/2" x 11" for laser or inkjet printers

Box quantity: 2500

Printed in red, OCR scannable ink in complaince with government standards

Medicare approved for billing Medicare Part A claims

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Price: $36.75

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Quantity: 5-9 Items 10-19 Items 20+ Items

Price: $34.25 $32.95 $28.95

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Rosedale, MD 21237

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